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General NPI Number Information
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NPI Number | 1508839812
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Entity Type | Individual
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Provider Name | SCOT ALAN CORDRAY MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 110 NW 3ST 2ND FLOOR
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City | LAWTON
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State | OK
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Zip | 73505-6100
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Country | US
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Telephone | 580-357-3671
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Fax | 580-357-1256
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M5108
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01081953A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | M5108
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | M5108
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | M5108
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 26784
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License Number State | OK
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